There is no denying that pure glucose or dextrose (the crystalline form of glucose) is by far the fastest and most accurate way to treat a low blood sugar level.

Dr. Bernstein's Diabetes Solution book states:

"Glucose, the sugar of blood sugar, does not have to be digested or converted in the liver to anything else. Unlike other sweets, it's absorbed into the blood directly thought the mucous membranes of the stomach and gut. Furthermore...we can compute precisely how much a fixed amount of glucose will raise blood sugar." Dr. Bernstein's Diabetes Solution book (2011) p. 339

Glucose tablets are portable, measurable, predictable and fast-Acting. It's the ideal combination.

But they lack one important criterion: readily available.

In my experience living on three continents within the last two years and working with people all over the world, I've learned that glucose tablets are not frequently available outside of the USA and Canada. In North America, we seem to assume that the same goods are available everywhere. They're not.

Glucose tablets are nearly impossible to find in some places of the world or so exorbitantly priced that they're out of reach of many.

So while not ideal, we do what we have to do.

As an alternative to glucose tablets, you can use 'Dr. Bernstein Approved' candy similar to 'Smarties" in the USA.

(Please note, these are different than Smarties in Europe). Dr. Bernstein also recommends 'Bottle caps" or SweeTARTS candies (or similar) as alternatives and lists these on page 343 of Dr. Bernstein's Diabetes Solution book. These small candies often contain nearly 100% glucose/dextrose and similar candies can be found in many countries.

Avoid any candy with a sugary shell such as Skittles, M&M's, Rocklets and many others, particularly chocolates, as these will be digested much slower due to the waxes and fats contained.

You also want to avoid treating a low blood sugar level with food or beverages. Food is not measurable, predictable or fast acting. When treating hypoglycemia with food, we usually end up eating far too much (defeating the Law of Small Numbers) before the symptoms of our low blood sugar are alleviated and as a result, creating a rebound-high.

Another approved alternative is glucose/dextrose powder which is normally more accessible than tablets.

Glucose powder and/or Dextrose granules are a great way to treat a low blood sugar level at home. You can measure the appropriate amount of powder/granules to treat your blood sugar level and mix with water to drink. Alternately, if you want to create a great chemistry experiment, you can attempt to make your own glucose tablets at home.

I've also tried powdered glucose packets available at some pharmacies that recommend pouring into the mouth directly. I DO NOT RECOMMEND these, nor do I recommend pouring ANY powdered glucose directly into your mouth because of the probability of aspirating (breathing in) the powder. Been there. Done that. Not fun.

Out of all of the options, the most accessible thing that I've found worldwide is sugar...

And I wrote about it here while living in Argentina for 5 years. While table sugar is not ideal because of the fructose/glucose combination which slightly slows the absorption, it's available in small packets which meets the requirements of portable, measurable, readily available and fast-acting (although as I mentioned, slightly slower than pure glucose).

Is TABLE sugar ideal to treat a low? No

Will it work? Yes

There are many tips and tricks to diabetes management-- which is obvious by the sheer size of Dr. Bernstein's Diabetes Solution book. We always want to remember the Law of Small Numbers and in the treatment of hypoglycemia, the key requirements of small, measurable, predictable corrections.

But I will never be a purist about glucose tablets. Glucose tablets are amazing and I highly recommend glucose tablets if you have access to them.

But if you can't get glucose tablets, look for the approved alternatives listed above.

Then there are other alternatives, like sugar, that I see as the lesser of all the other evils.

I will never say that glucose is the ONLY way to effectively treat a low blood sugar level because I've been there for years - without any access to glucose tablets - and using what I could to keep the corrections small, measurable and predictable.

We all do what we have to do.

For more information on Hypoglycemia and the Treatment of Lows (including a chart on how to calculate your corrections based on body weight) click the red link to the diaVerge article.

If you're interested in making a change towards more optimal diabetes management and don't know where to start, or have questions, we'd love to help you improve your diabetes management and quality of life. More info at diaVerge Diabetes Education & Coaching.

If you still haven't read Dr. Bernstein's Diabetes Solution book or want to buy another copy as a gift to your doctor or a friend, click the link to buy it on Amazon.